Getting the shingles vaccine after age 50

Cost: The recombinant shingles vaccine requires two doses, costing roughly 3,000 to 4,000 yuan in total. This expense must be paid out of pocket.
In plain terms: In Phase 3 trials, this vaccine proved 97% effective at preventing shingles across all age groups. The downside is that both doses cost several thousand yuan, all paid by the patient. In exchange, there’s a 97% reduction in the likelihood of developing shingles.
Benefit: This Phase 3 trial involved 15,400 participants from 18 countries. Participants were randomly assigned to receive either the vaccine or a placebo, with follow-up lasting an average of 3.2 years. Over that time, 6 cases of shingles occurred in the vaccine group versus 210 in the placebo group. Expressed per 1,000 person-years, these figures translate to 0.3 versus 9.1 cases. One thousand person-years represents the number of cases observed in a group of 1,000 people over one year. The original report states, “The overall vaccine efficacy against shingles is 97.2% (95% CI 93.7–99.0, P<0.001).” Effectiveness ranged from 96.6% to 97.9% across all age brackets.
Evidence grade: A
Sources:Lal H, Cunningham AL, Godeaux O, et al. (2015). Efficacy of an adjuvanted herpes zoster subunit vaccine in older adults. New England Journal of Medicine, 372(22), 2087-2096. https://doi.org/10.1056/NEJMoa1501184
Notes: This option ranks low in terms of cost-effectiveness primarily due to its high price. While shingles itself rarely proves fatal, its most troublesome complication is post-herpetic neuralgia, which can persist for months or even years. After vaccination, a notable percentage of recipients experience pain at the injection site and fever. In particular, severe side effects (graded as Grade 3) occurred in 17.0% of vaccine recipients versus 3.2% of those given a placebo.